Hypoventilation central

Unlabeled Uses Sleep apnea, congenital central hypoventilation syndrome, obesity-hypoventilation syndrome, postanesthetic respiratory depression, shivering... 

Pine DS, Weese-Mayer DW, Silvestri JM, et al Anxiety and congenital central hypoventilation syndrome. Am J Psychiatry 151 864-870, 1994 Pine DS, Cohen P, Brook J Emotional problems during youth as predictors of stature during early adulthood results from a prospective epidemiologic study. Pediatrics 97 856-863, 1996a... 

False SUFFOCATION ALARM THEORY This theory proposes that panic disorder patients have a suffocation monitor located in the brainstem, which misinterprets signals and misfires, triggering a false suffocation alarm (panic attack). Many factors are consistent with this hypothesis, including the above-mentioned theory of chronic hyperventilation and carbon dioxide hypersensitivity. The disorder of On-dine s curse (congenital central hypoventilation syndrome) appears to be virtually the opposite of panic disorder and is characterized by a diminished sensitivity of the... 

Congenital central hypoventilation PMX2B syndrome (CCHS) Ondine s (PHOX2B) Transcription factor (20 25-33)... 

The authors questioned the safe use of propofol in congenital central hypoventilation syndrome, which is a generalized disorder of autonomic function. 

Infections of the CNS such as encephalitis and meningitis Comatose states such as cerebrovascular accident due to intracranial hemorrhage Primary central hypoventilation... 

Central hypoventilation syndrome, anorexia nervosa, bulimia nervosa, memory impairment, obsessive-compulsive disorder... 

Central hypoventilation Deceleration/acceleration of head growth Blindness (cortical)... 

Shirasawa S, Arata A, Onimaru H, Roth KA, Brown GA, Homing S, Arata S, Okumura K, Sasazuki T, Korsmeyer SJ. Rnx deficiency results in congenital central hypoventilation. Nat Genet 2000 24 287-290. 

Cutz E, Ma TKF, Perrin DG, Moore AM, Becker LE. Peripheral chemoreceptors in congenital central hypoventilation syndrome. Am J Respir Crit Care Med 1997 155 358-363. 

Diaphragmatic pacing is a viable alternative to PPV for a small number of carefully selected patients, with SCI or central hypoventilation. Regular assessments by an experienced clinical team, backup ventilation, GPB, effective secretion management, and appropriate education will enable these complex patients to enjoy increased independence and an improved quality of life. 

OHS, previously called the Pickwickian syndrome (6), is defined as the association of obesity, sleep-disordered breathing (SDB) with daytime h)q)ersomnolence, and hypercapnia (Pacc>2 > 45 mmHg) in the absence of any other respiratory disease (Fig. 1). SDB can present as obstructive apneas and hypopneas, obstructive hypoventilation due to increased upper airway resistance, and/or central hypoventilation (7). The prevalence of OHS is 36% in patients with BMI between 35 and 40 kg/m, and 48%, if BMI equals or exceeds 50 (8). Without adequate treatment, patients with OHS develop cor pulmonale and recurrent episodes of hypercapnic respiratory failure, and loss of survival (Fig. 2). OHS is one of the many etiologies of CRF and has become a growing indication to initiate longterm noninvasive ventilation (NIV) in most European countries (9,10). 

Ventilatory impairment results from inspiratory muscle weakness, central hypoventilation, thoracic restriction, upper airway narrowing, extreme obesity, abdominal distension, and improperly fitting thoracolumbar orthoses. In NMD, pulmonary infiltrates and respiratory failure are precipitated by mucus plugging due to an ineffective secretion clearance, especially during acute respiratory infections (2,7). 

Infants and children may require long-term ventilatory support due to three categories of diseases that may impair the ventilatory balance increased respiratory load (due to intrinsic cardiopulmonary disorders, upper airway abnormalities, or skeletal deformities), ventilatory muscle weakness [due to neuromuscular diseases (NMD) or spinal cord injury], or failure of neurological control of ventilation (with central hypoventilation syndrome being the most common presentation) (Fig. 1). 

Gozal D. Congenital central hypoventilation syndrome an update. Pediatr Pulmonol 1998 26 273-282. 

Zaccaria S, Braghtroli A, Sacco C, et al. Central hypoventilation in a seven year old boy. Longterm treatment by nasal mask ventilation. Monaldi Arch Chest Dis 1993 48 37-38. 

Figure 3 Percentage of users in each disease category by country. The symbol represents lung/ airways (COPD, cystic fibrosis, bronchiectasis, pulmonary fibrosis, and pediatric diseases) , chest wall deformities (kyphoscoliosis, old TB, OHS, surgical resection) and , neuromuscular disorders (muscular dystrophy, motor neuron disease, post-polio kyphoscoliosis, central hypoventilation, spinal cord damage, and phrenic nerve palsy). Abbreviations COPD, chronic obstructive pulmonary disease TB, tuberculosis OHS, obesity hypoventilation syndrome. Source From Ref. 15.

By 1994, fees paid by medical insurance increased to cover medical services provided by the hospital, clinic, or home care nurse as well as the costs of medical equipment, such as the ventilator rental. This led to rapid growth in the population of patients receiving HMV (2). In April 1995, of the 536 HMV cases 65% had NMD, 20% had parenchymal disease (PD), such as sequelae of tuberculosis and chronic obstructive pulmonary disease (COPD), and 15% had thoracic restriction or central hypoventilation syndrome (3,4). In June 1995, of the 1006 patients undergoing LTV for at least three months, 215 (21%) could have been discharged to a home care setting if an appropriate public assistance program had been established (3,4). By January 1997, there were 1250 patients receiving HMV of whom 461 (1.2 people/million) used noninvasive positive pressure ventilation (NIPPV) (5). 

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